Effects of negative emotions and internet overuse on smoking behavior among adolescents with different socioeconomic condition

  Objective  To explore the prevalence of negative emotion and and internet use and their influence on smoking behavior among adolescents with different socioeconomic condition and to provide evidences for interventions on smoking in the adolescents.

  Methods  Using stratified random cluster sampling, we recruited 1 989 students aged 11 – 18 years in 4 high schools in 4 cities of Hunan province for a survey from December 2016 to January 2017. Beck Depression Inventory-Ⅱ-Chinese Version (BDI-II-C), Social Anxiety Scale for Adolescents (SAS-A), Internet Addiction Scale – Chinese Version (IAS-C), Social Class Questionnaire, and a self-designed questionnaire on smoking behavior were administered among the students.

  Results  Among the 1 634 students with valid responses, the reported prevalence rate of smoking was 22.2% and most of the smokers were boy students (92.3%, 335/363); the prevalence rate of smoking differed significantly among the students with different socioeconomic conditions, with the rates of 4.8%, 24.2%, and 33.3% for the students with high, moderate, and low socioeconomic condition (χ² = 51.28, P < 0.001). There were significant differences in the reported negative emotion and internet overuse between the students with high and low socioeconomic condition (P < 0.001). Smoking behavior was positively correlated with depression, social anxiety and internet overuse, but inversely correlated with socioeconomic condition among the students. Logistic regression showed that gender (odds ratioOR = 0.18), grade (OR = 1.65), residence (OR = 1.24), socioeconomic condition (OR = 0.94), depression (OR = 1.07), avoidance and distress in unfamiliar situations (OR = 0.93), avoidance and distress in general situations (OR = 1.10), interpersonal health (OR = 0.93) and time management (OR = 1.11) were significant predictors for smoking.

  Conclusion  The boy students, the students with low socioeconomic condition, poor interpersonal relation, high depression score, and in high schooling grade are more likely to smoke in social situations.